BACKGROUND Parenting programs suitable for delivery at scale in low-resource contexts are urgently needed. We conducted a randomized trial of Parenting for Lifelong Health (PLH) for Young Children, a low-cost 12-session program designed to increase positive parenting and reduce harsh parenting and conduct problems in children aged 2-9. METHODS Two hundred and ninety-six caregivers, whose children showed clinical levels of conduct problems (Eyberg Child Behavior Inventory Problem Score, >15), were randomly assigned using a 1:1 ratio to intervention or control groups. At t0 , and at 4-5 months (t1 ) and 17 months (t2 ) after randomization, research assistants blind to group assignment assessed (through caregiver self-report and structured observation) 11 primary outcomes: positive parenting, harsh parenting, and child behavior; four secondary outcomes: parenting stress, caregiver depression, poor monitoring/supervision, and social support. TRIAL REGISTRATION ClinicalTrials.gov (NCT02165371); Pan African Clinical Trial Registry (PACTR201402000755243); Violence Prevention Trials Register (http://www.preventviolence.info/Trials?ID=24). RESULTS Caregivers attended on average 8.4 sessions. After adjustment for 30 comparisons, strongest results were as follows: at t1 , frequency of self-reported positive parenting strategies (10% higher in the intervention group, p = .003), observed positive parenting (39% higher in the intervention group, p = .003), and observed positive child behavior (11% higher in the intervention group, p = .003); at t2, both observed positive parenting and observed positive child behavior were higher in the intervention group (24%, p = .003; and 17%, p = .003, respectively). Results with p-values < .05 prior to adjustment were as follows: At t1 , the intervention group self-reported 11% fewer child problem behaviors, 20% fewer problems with implementing positive parenting strategies, and less physical and psychological discipline (28% and 14% less, respectively). There were indications that caregivers reported 20% less depression but 7% more parenting stress at t1 . Group differences were nonsignificant for observed negative child behavior, and caregiver-reported child behavior, poor monitoring or supervision, and caregiver social support. CONCLUSIONS PLH for Young Children shows promise for increasing positive parenting and reducing harsh parenting.

中文翻译：

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为幼儿终身健康育儿：南非育儿计划的随机对照试验，以防止严厉的育儿和儿童行为问题。

背景技术迫切需要适合在资源匮乏环境中大规模实施的育儿计划。我们开展了一项针对幼儿终身健康 (PLH) 的随机试验，这是一项为期 12 节的低成本计划，旨在增加 2-9 岁儿童的积极养育并减少严厉的养育和行为问题。方法 将 296 名儿童表现出临床行为问题水平（Eyberg 儿童行为量表问题评分，>15）的看护人以 1:1 的比例随机分配到干预组或对照组。在 t0 、随机化后 4-5 个月 (t1 ) 和 17 个月 (t2 ) 时，对分组分配不知情的研究助理评估了（通过照顾者自我报告和结构化观察）11 项主要结果：积极养育、严厉养育和孩子行为; 四个次要结果：养育压力、照顾者抑郁、监督/监督不力和社会支持。试验注册 ClinicalTrials.gov (NCT02165371)；泛非临床试验注册中心 (PACTR201402000755243)；暴力预防试验注册 (http://www.preventviolence.info/Trials?ID=24)。结果 护理人员平均参加了 8.4 次会议。调整 30 次比较后，最强结果如下：在 t1 时，自我报告积极养育策略的频率（干预组高 10%，p = .003），观察到积极养育策略（干预组高 39%， p = .003），并观察到积极的儿童行为（干预组高 11%，p = .003）；在 t2，观察到的积极养育和观察到的积极儿童行为在干预组中都更高（24%，p = .003；17%，p = .003，分别）。调整前 p 值 < .05 的结果如下：在 t1 时，干预组自我报告的儿童问题行为减少了 11%，实施积极养育策略的问题减少了 20%，身体和心理纪律更少（28%和 14%，分别）。有迹象表明，在 t1 时，照顾者报告的抑郁症减少了 20%，但育儿压力增加了 7%。观察到的儿童消极行为、看护者报告的儿童行为、监督或监督不力以及看护者的社会支持方面的组差异不显着。结论 适用于幼儿的 PLH 显示出增加积极养育和减少严厉养育的前景。干预组自我报告的儿童问题行为减少了 11%，实施积极养育策略的问题减少了 20%，身体和心理纪律也减少了（分别减少了 28% 和 14%）。有迹象表明，在 t1 时，照顾者报告的抑郁症减少了 20%，但育儿压力增加了 7%。观察到的儿童消极行为、看护者报告的儿童行为、监督或监督不力以及看护者的社会支持方面的组差异不显着。结论 适用于幼儿的 PLH 显示出增加积极养育和减少严厉养育的前景。干预组自我报告的儿童问题行为减少了 11%，实施积极养育策略的问题减少了 20%，身体和心理纪律也减少了（分别减少了 28% 和 14%）。有迹象表明，在 t1 时，照顾者报告的抑郁症减少了 20%，但育儿压力增加了 7%。观察到的儿童消极行为、看护者报告的儿童行为、监督或监督不力以及看护者的社会支持方面的组差异不显着。结论 适用于幼儿的 PLH 显示出增加积极养育和减少严厉养育的前景。有迹象表明，在 t1 时，照顾者报告的抑郁症减少了 20%，但育儿压力增加了 7%。观察到的儿童消极行为、看护者报告的儿童行为、监督或监督不力以及看护者的社会支持方面的组差异不显着。结论 适用于幼儿的 PLH 显示出增加积极养育和减少严厉养育的前景。有迹象表明，在 t1 时，照顾者报告的抑郁症减少了 20%，但育儿压力增加了 7%。观察到的儿童消极行为、看护者报告的儿童行为、监督或监督不力以及看护者的社会支持方面的组差异不显着。结论 适用于幼儿的 PLH 显示出增加积极养育和减少严厉养育的前景。